Cardiologist Eric Topol on why we need to map the human body and “go deep” with big data

This year’s Big Data in Biomedicine conference included a passionate talk from cardiologist Eric Topol, MD, of The Scripps Research Institute. Topol, who has been named one of the most influential physician leaders in the United States, described in gripping detail what’s wrong with medical care today and why we need to move forward to the kind of individualized medicine that can make for healthier individuals and healthier populations.

The key, Topol said, is moving "from where we see people as all the same, which is the way medicine is practiced and the way we give out drugs and diagnoses and do screenings, to ending this concept of an 'average person,' who doesn't exist."

"Where we are in 2017 is remarkably primitive," he said, quickly reviewing a series of surprising facts about U.S. health care. For example, mass screenings, which are intended to catch diseases early, often do more harm than good. Of every 10,000 mammograms, he said, only five actually benefit the patient, while thousands are false positives that can cause actual harm.

He said we should be able to do "better than that if we can define each individual," but "we haven't had the tools to do -- until now."

Topol suggested that we map human beings using approaches that resemble the geographic information system (GIS) maps, which geographers, mapping apps, and urban and county planners use to understand different layers of information about the world. It's now possible to do with that humans, he said.

Today, a person's environment, behavior, dynamic physiology, and proteomics can all be quantified and tracked. Sensors can track changes in time and algorithms can integrate multiple data streams.

"You can accurately track your blood pressure through your watch," said Topol. You can see how your blood pressure reacts when you are in traffic or having a heated discussion with your spouse, he joked.

And it's just as easy for anyone to see what foods cause a glucose spike. In fact, he said, ordinary healthy individuals who don't have diabetes are now monitoring their glucose as a preventive. "Verily is working on a sensor that will make finger sticks obsolete," he pointed out.

As part of its work for the Precision Medicine Initiative, Scripps is enrolling 350,000 people by combining cohorts from Walgreens and Quest clinics, blood banks and other groups.

"This is a new way of doing clinical trials," he said. "You have participants enrolling through smart phones and mobile devices and the data is shared with participants -- and you can actually help people with their care."

And it's important, Topol said, to not just collect massive amounts of data -- but to use it for meaningful analysis. "We need to go beyond 'big' and go deep, he said.

The scenario many of us learned in school is that two X chromosomes make someone female, and an X and a Y chromosome make someone male. These are simplistic ways of thinking about what is scientifically very complex.